Self-management

In conjunction with traditional pain management, there are a number of self-management strategies that can help reduce pain levels and improve your quality of life. Don’t underestimate your ability to have an impact on your health and pain levels!

Here are some areas where lifestyle changes can help improve pain:

  1. Activity modification
  2. Exercise
  3. Diet and nutrition
  4. Sleep hygiene
  5. Stress reduction

Activity modification

Restricting or modifying your activities may seem obvious, but it can be difficult to adjust when you’re used to being able to do certain things a certain way. It can take many years of trial and error to identify your body’s limitations and specific triggers for pain, and then to find strategies to work with or around them. Be patient with yourself as you explore your body’s limits—and abilities.

You will need to determine what your limitations are, but perhaps it’s that you need to lie down for 10 minutes every two hours. Or maybe you find you can go for a 30-minute walk, but you need to allow 30 minutes of rest before and afterward. Perhaps you need a standing desk instead of a seated one to work at your computer comfortably. As you get to know your body, keep in mind there is a fine balance between getting appropriate rest and recuperation—and keeping up your strength, mobility, and stamina as much as possible. Don’t be afraid to get creative with accommodating your body’s needs. Investigate assistive devices, like braces or mobility tools, such as canes. Consider adaptive technology, too. For example, if typing on a computer is challenging, you may want to look into dictation software.

Occupational therapists can be very helpful in coming up with solutions for keeping up with your daily activities and continuing to do the things you enjoy. If you work, ask your manager about getting an assessment from an ergonomics specialist. Remember that you have a right to reasonable accommodations for your health in the workplace.

Exercise

As difficult as it is to get yourself moving when you have chronic pain, it’s also extremely important. Here are four key reasons to get moving:

  1. Maintaining a healthy weight. Excess body weight puts extra strain on your joints, muscles and organs.
  2. Cardiovascular health. Too little activity can result in disabling cardiovascular conditions, from orthostatic intolerance to heart disease. Your body already has enough to deal with with chronic pain – don’t add heart, circulation, and lung problems to the list!
  3. Strength, flexibility, and stamina. Chronic pain can negatively impact your strength, flexibility, and stamina, which in turn increase your pain and level of disability.
  4. Endorphins! Aerobic exercise produces endorphins, the feel-good chemicals that act as your body’s natural painkillers.

Start small and increase the intensity of your workout as your body allows. Remember that any exercise is better than nothing at all; just do the best you can. Here are some ideas for exercise to get you started:

  • Yoga or tai chi. Some types of yoga are directly tailored to individuals who have physical limitations. Try searching for a YouTube video for “Restorative yoga,” or “chair yoga.” Tai chi is also a fabulous, gentle way to encourage flexibility and stability.
  • Aquatic exercise. Pool therapy is great for those with musculoskeletal problems. It provides a gentle, low-impact way to get a workout. You can try your own exercises, find a group class, or a physical therapist who specializes in designing one-on-one aquatic exercises. Some pools are heated, to make it even easier on your joints and muscles.
  • Even a short walk is good! Turn on your headphones and listen to a podcast or audiobook to help distract and encourage yourself.
  • Short bursts of cardio. Science has shown that even one minute of all-out exercise has benefits. The key is to get your heart rate up and your blood bumping. Start small with a few minutes of exercise and build up slowly. Chronic pain-friendly cardio ideas include using reclining bikes and elliptical machines.

Please note: we recommend checking with a clinician before beginning any exercise program to ensure it is safe for you.

Diet and nutrition

A thoughtful, balanced diet is key to maintaining a healthy weight, reducing inflammation, and getting important nutrients that support your overall wellbeing. Some people find that certain types of diets lessen their pain, such as an anti-inflammatory diet; a vegetarian or vegan diet; a paleo diet; a gluten-free diet; and so on. Explore different diets to find out what works for you!

Regardless of whether you follow a specific set of guidelines surrounding food, here are some key principals that hold true:

  • Eat as many fresh vegetables and fruits as humanly possible.
  • Limit extremely sugary and processed foods.
  • Avoid foods with “bad” fats, like trans fats and saturated fats.
  • Eat more foods that have “good” fats, like fish, avocados, nuts, and olive oil.
  • Stay hydrated. The Institute of Medicine recommends 7 liters (15 cups) for the average adult male and 2.7 liters (11 cups) for the average adult female.

If you’re interested in extra help with your diet, consider meeting with a licensed nutritionist.

Sleep

An estimated 50 percent to percent of people with chronic pain have ongoing sleep difficulties.[1] Studies show that inadequate sleep, however, can exacerbate pain.[2] Here are some tips for ensuring you get a good night’s rest despite pain.

  • Establish a routine.Going to bed and waking up at the same time every day—even on the weekends—reinforces the natural sleep-wake cycle in your body. You can also help reinforce bedtime by establishing a wind-down routine, e.g. by taking a bath, meditating, reading or listening to soothing music.
  • Create a restful environment. Turn on white noise, use ear plugs, invest in comfortable bedding, and keep the room temperature cool. Exposure to light is especially important: dim or turn off the lights in your house 30 to 60 minutes before going to bed. The light from cell phone and TV screens can also interfere with circadian rhythms, so shut down all devices as you prepare for bed.
    • Watch what you eat and drink. Caffeinated products—like tea or coffee, chocolate—anything containing nicotine, or any other stimulants should be avoided for at least four to six hours before you plan to go to sleep. Even alcohol, which initially makes you feel tired, makes it harder to get high-quality sleepy. Furthermore, heavy meals and too many fluids before bed might keep you up because you are uncomfortable or need to use the bathroom.
    • Get tired! Napping during the day can interfere with sleep at night. If you must, limit your snooze to 30 minutes, and give yourself at least four hours between the nap and bedtime. In addition, exercising during the day helps tire out your body and can foster better sleep at night. Try to work out at least a few hours before bed, if possible.

Still struggling? Ask your doctor about meeting with a sleep specialist.

Reduce stress

Pain increases stress, and stress increases pain. But you can break this cycle by proactively trying to reduce stress wherever possible. Multiple studies have shown that reducing stress and relaxation techniques can improve overall health and wellbeing, and may even reduce pain or improve the perception of pain.[3],[4]

Some examples of stress reduction techniques and strategies include:

  • Meditation
  • Relaxation techniques such as breathing exercises, progressive muscle relaxation, visual imagery, and mindfulness
  • Music, art or dance therapy
  • Journaling
  • Exercise
  • Support groups
  • Counseling and cognitive behavioral therapy

Generally speaking, reducing stress with chronic pain also requires:

  • Pacing yourself to allow for sufficient rest and recovery;
  • Learning to say no and putting your health first;
  • Focusing on the things you can do and not what you can’t;
  • Communicating clearly with your loved ones about your needs and challenges;
  • Letting go of guilt and shame surrounding pain.

For more advice on managing stress when you have pain, find a psychologist, counselor or life coach in your area.

[1] https://www.ncbi.nlm.nih.gov/pubmed/27208716

[2] https://www.ncbi.nlm.nih.gov/pubmed/26498229

[3] http://journals.sagepub.com/doi/abs/10.1177/070674370805300402

[4] http://www.sciencedirect.com/science/article/pii/S0022399909000944